Neurobion N20 coated pills
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Active ingredients
Pyridoxine + Thiamine + Cyanocobalamin
The brand
Neyrobion
Release form
Pills
Composition
Thiamine disulfide (Vit. B1) 100 mg; Pyridoxine hydrochloride (Vit. B6) 200 mg; Cyanocobalamin (Vit. B12) 200 μg *; * The amount of cyanocobalamin, including an excess of 20%, is 240 μg.; Auxiliary substances: magnesium stearate - 2.14 mg, methylcellulose - 4 mg, corn starch - 20 mg, gelatin - 23.76 mg, lactose monohydrate - 40 mg, talc - 49.86 mg.; Shell composition: mountain glycolic wax - 300 mcg, gelatin - 920 mcg, methylcellulose - 1.08 mg Arabic acacia - 1.96 mg, glycerol 85% - 4.32 mg, povidone-25 thousand - 4.32 mg, calcium carbonate - 8.64 mg, colloidal silicon dioxide - 8.64 mg, kaolin - 21.5 mg, titanium dioxide and - 28 mg talc - 47.1 mg Sucrose - 133.22 mg.
Pharmacological effect
The complex of vitamins of group B. The vitamins contained in the preparation - thiamine (B1), pyridoxine (B6) and cyanocobalamin (B12) - are neurotropic substances and play a special role as coenzymes in the intermediate metabolism occurring in the central and peripheral nervous system. Like other vitamins, they are essential nutritional components that the body cannot synthesize on their own. The therapeutic use of vitamins B1, B6 and B12 compensates for the often insufficient intake of vitamins from food, h to ensure the availability in the body the required amount of co-enzymes. The use of vitamins of group B in the form of a complex increases their therapeutic efficacy, since the effectiveness of the combination exceeds the efficiency of individual components. The therapeutic use of these vitamins in various diseases of the nervous system is aimed, on the one hand, to compensate for the existing deficiency (possibly due to increased need directly caused by the disease) and, on the other hand, to stimulate the natural mechanisms aimed at recovery. those so, indirect analgesic action of vitamin B complex has a beneficial effect on the therapeutic outcome.
Pharmacokinetics
Thiamine; After ingestion, thiamine undergoes a dose-dependent transport, the mechanism of which is dual in nature: active absorption at concentrations up to 2 mcmol / L and passive diffusion at concentrations above 2 mcmol / L. Thiamine phosphorylation occurs in the liver. T1 / 2 is about 4 hours. In the human body contains about 30 mg of thiamine.Taking into account the rapid metabolism, it is removed after 4-10 days.; Pyridoxine; Pyridoxine is absorbed very quickly, mainly in the upper intestine and is excreted after a maximum of 2-5 hours. Performing the function of coenzyme requires pyridoxine phosphorylation. Pyridoxine in the phosphorylated form (pyridoxal phosphate) is almost 80% bound to plasma proteins.; In the human body contains about 40-150 mg. During the day, 1.7-3.6 mg is excreted in the urine. Cyanocobalamin; Cyanocobalamin is absorbed from the gastrointestinal tract through 2 mechanisms: 1) release under the action of gastric juice and fast binding to an intrinsic factor; 2) passive diffusion through the intestinal epithelium, regardless of intrinsic factor.; At doses of more than 1.5 μg, the latter mechanism plays a significant role. In patients with B12-deficient anemia, reabsorption after oral administration is approximately 1% of 100 μg or more.; Excess cyanocobalamin accumulates in the liver. The metabolic rate of cyanocobalamin per day is 2.5 μg.
Indications
In the complex therapy of neuritis and neuralgia: - trigeminal neuralgia; - neuritis of the facial nerve; - intercostal neuralgia; - pain syndrome caused by diseases of the spine (lumbar ischialgia, plexopathy, radicular syndrome caused by degenerative changes in the spine).
Contraindications
- hypersensitivity to the drug; - age up to 18 years (due to the high content of active substances); - hereditary intolerance to galactose or fructose, lactase deficiency, glucose-galactose malabsorption or sugar-isomaltase deficiency (the product contains lactose and sucrose).
Use during pregnancy and lactation
During pregnancy and lactation, the use of the drug Neurobion; It is not recommended due to the high vitamin content. Vitamins B1, B6 and B12 are excreted in breast milk, but the risk of an overdose in the newborn has not been established. In some cases, intake of vitamin B6 in high doses (> 600 mg / day) may suppress the secretion of breast milk. If necessary, taking the drug during lactation, breastfeeding should be stopped.
Dosage and administration
Tablets are taken orally, without chewing, with a small amount of water, during or after a meal.; The drug should be taken on 1 tab. 3 times / day or as prescribed by a doctor. The duration of treatment is determined by the doctor and averages 1-1.5 months.; Dose adjustment of the drug during therapy for more than 4 weeks is recommended.
Side effects
Determination of the frequency of adverse reactions: very often (≥1 / 10), often (≥1 / 100, <1/10), infrequently (≥1 / 1000, <1/100), rarely (≥1 / 10 000, <1 / 1000), very rarely (<1/10 000, including individual messages), frequency not established (frequency cannot be estimated from the available data); From the immune system: very rarely - hypersensitivity reactions, such as sweating, tachycardia.; Allergic reactions: very rarely - itching, hives.; On the part of the digestive system: the frequency has not been established - nausea, vomiting, diarrhea, abdominal pain.
Overdose
Symptoms; Vitamin B1 - thiamine has a wide therapeutic range. In very high doses (> 10 g), it has a ganglion-blocking effect and suppresses the transmission of nerve impulses, i.e. has a muscle relaxant effect.; Vitamin B6 - pyridoxine has very low toxicity. The use of pyridoxine for 2 months or more at a dose of more than 1 g / day can cause neurotoxic effects. With an overdose after ingestion of more than 2 g / day - neuropathy with ataxia, impaired sensitivity, cerebral seizures with ECG changes, and, in some cases, hypochromic anemia and seborrheic dermatitis; Vitamin B12 - after parenteral administration in high doses, and also in rare cases, after oral administration, eczematous changes in the skin and a benign form of acne have been observed. Treatment: washing the digestive tract, taking activated charcoal, conducting symptomatic therapy.
Interaction with other drugs
When used simultaneously with levodopa, pyridoxine may reduce the anti-Parkinsonian effect of levodopa. Simultaneous use of pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine) may increase the need for pyridoxine. Thiamine is inactivated by fluorouracil. Fluorouracil competitively inhibits the phosphorylation of thiamine to thiamine pyrophosphate.; Antacids reduce the absorption of thiamine.; "Loop" diuretics, for example, furosemide, can block tubular reabsorption, thusenhancing the excretion of thiamine with prolonged use, which leads to a decrease in the content of thiamine in the blood. Acceptance of alcohol and black tea leads to a decrease in the absorption of thiamine. Drinks containing sulfites (eg wine), increase the degradation of thiamine.
special instructions
With prolonged use (more than 6-12 months) of vitamin B6 at a dose of 50 mg / day, peripheral sensory neuropathy may occur. Therefore, with long-term therapy, it is recommended to regularly monitor the patient’s condition. If signs of peripheral sensory neuropathy (paresthesia) appear, it is necessary to adjust the dose and, if necessary, discontinue the drug. can lose their specificity.; Influence on ability to drive motor transport and control mechanisms; Neurobion does not affect the ability to drive vehicles and management mechanisms.